Vitamins Direct healthiest weight loss and Diets

Why do people follow this diet

The Atkins Diet is attractive to dieters who have tried unsuccessfully to lose weight on low-fat, low-calorie diets. Atkins dieters can eat as many calories as desired from protein and fat, as long as carbohydrate consumption is restricted. As a result, many Atkins dieters are spared the feelings of hunger and deprivation that accompany other weight loss regimens.

What do the advocates say

The underlying premise of the Atkins Diet is that diets high in carbohydrates cause some people to gain weight and can ultimately lead to obesity. Such diets increase the production of insulin (a hormone secreted by the pancreas). When insulin levels are high, the food we eat is quickly and easily converted into fat, and stored in our cells. By restricting the consumption of carbohydrates, the production of insulin is moderated. In addition, the lack of available carbohydrate (the bodys preferred fuel source) forces the body to burn stored fat as energy.

The changes in metabolism that occur with severe carbohydrate restriction also cause the body to excrete ketones (breakdown product of fat metabolism) in the urine. As ketones contain calories, the loss of ketones in the urine may enhance weight loss.

Until his death in 2003, Dr. Atkins and his colleagues at The Atkins Centre for Complementary Medicine in New York have used this diet to treat patients with obesity, as well as non-insulin dependent (type 2) diabetes mellitus (NIDDM), high cholesterol and triglycerides, and elevated blood pressure. Although there has been little scientific research investigating the diet, several supportive studies were published around the time of Dr. Atkins death.

Osteoporosis

People with osteoporosis have brittle bones, which increases the risk of bone fracture, particularly in the hip, spine, and wrist. Although the risk of becoming osteoporotic is tied to genetics as well as many dietary and lifestyle issues, the true cause of this condition remains somewhat unclear. One key to osteoporosis prevention is the attainment of maximum peak bone mass during the first 3035 years of life. This means that dietary and lifestyle habits that help prevent osteoporosis should begin as early in life as possible. During middle and old age, osteoporosis prevention focuses primarily upon slowing down the rate of bone loss.

Factors Associated with Osteoporosis

Age

Hormone deficiency

Alcohol

Medications

Body weight

Protein intake

Caffeine

Race

Calcium

Salt

Other minerals

Smoking

Exercise

Soy

Family history

Vitamin A

Gastrointestinal disease

Vitamin D

Gender

Age
People of advanced age have a higher risk of osteoporosis, resulting from cumulative years of gradual bone loss starting before middle age. They also have an increased risk of falling, due to changes in vision, strength, and balance. Together, these factors contribute to the large number of fractures experienced by older people.1 People with long life expectancy should adopt dietary and lifestyle habits that will maximize peak bone mass early in life and minimize the bone loss that occurs naturally with aging.

Alcohol
Chronic alcohol abuse appears to increase bone loss and contributes to osteoporotic fractures. However, mild to moderate drinking may result in greater bone density than no alcohol intake at all,2 3 4 possibly due to increases in estrogen. Of course, alcohol consumption is associated with other health hazards, such as breast and other cancers, liver disease, alcoholism, and accidents, so its use may not be appropriate in many people, despite the potential lowering of osteoporosis risk.

Body weight
Higher body weight reduces the risk of osteoporosis and related fractures, primarily because more weight on bones causes them to increase their density to support that weight.5 6 Moreover, researchers have shown that people who successfully lose weight have greater loss of bone compared with those who do not lose weight.7 Therefore, people who lose weight need to be more vigilant about preventing osteoporosis.

Due to health consequences associated with being overweight, healthcare professionals do not recommend weight gain for most people in order to reduce the risk of osteoporosis. However, very underweight people, such as those with anorexia nervosa, not only produce less weight-bearing pressure, but also produce less bone-protecting hormones, and may have many nutritional deficiencies that contribute to an increased risk of bone loss.8 9 Weight gain in underweight people may reduce the risk of osteoporosis.

Caffeine
Caffeine has been linked to fracture of the hip in a large study following American women for six years.10 Caffeine increases urinary loss of calcium.11 In one trial, caffeine was linked with lower bone mass but only in women who consumed relatively little calcium.12 The authors of this report concluded that two to three cups of coffee per day might speed bone loss in women with calcium intakes of less than 800 mg per day. Most nutritionally oriented doctors recommend decreasing caffeine intake from caffeinated coffee, black tea, and some soft drinks as a way to improve bone mass.

In a group of 980 postmenopausal women, lifetime caffeine intake equal to two cups of coffee per day associated with decreased bone density in those who did not drink at least one glass of milk daily during most of their life.13 However, in 138 postmenopausal women, long-term dietary caffeine (coffee) intake was not associated with bone density.14 Until more is known, postmenopausal women should limit caffeine consumption and consume a total of approximately 1,500 mg of calcium per day (from a combination of diet and supplements).

Calcium
Good calcium nutrition throughout life is essential for achieving peak bone mass and preventing deficiency-related bone loss.15 Many trials have investigated the effects of calcium supplements on bone mass. Although insufficient when used as the only intervention, calcium supplements have helped to prevent osteoporosis.16 Though some of the research remains controversial, the protective effect of calcium on bone mass is one of very few health claims permitted by the U.S. Food and Drug Administration.

In several studies, calcium intake has not correlated with protectionfor example in men17 or in women who have just started menopause.18 Moreover, even most positive studies focusing on the effects of isolated calcium supplementation on bone mass show only minor effects. Nonetheless, a review of the research shows that calcium supplementation plus hormone replacement therapy is much more effective than hormone replacement therapy without calcium.19 Double-blind research has found that increasing calcium intakes results in greater bone mass in girls.20 An analysis of many studies investigating the effects of calcium supplementation in premenopausal women has also shown a significant positive effect.21 Studies in elderly people also confirm the value of calcium supplementation to prevent bone loss and fractures in older individuals.22 23 Most doctors, recommend calcium supplementation as a way to partially reduce the risk of osteoporosis. In order to achieve the 1,500 mg per day calcium intake deemed optimal by many researchers, 8001,000 mg of supplemental calcium are generally added to diets that commonly contain between 500700 mg calcium.

Other minerals
Low intake of minerals other than calcium may play a role in bone loss.24 25 26 One study reported that a daily combination of 1,000 mg calcium, 15 mg zinc, 2.5 mg copper, and 5 mg manganese was superior to calcium alone in preventing bone loss in postmenopausal women.27 Another study found that magnesium supplementation of at least 250 mg per day for two years arrested bone loss in most postmenopausal women.28

Exercise
Exercise is known to help protect against bone loss29 and osteoporotic fracture, even in older people.30 31 Most types of weight-bearing exercise done by men and postmenopausal women, including walking, dancing, running, and some weight-training activities, increase bone mass in the spine and hip and lower the risk of osteoporosis at these sites.32 33 34 While more frequent and intense exercises have the greatest effect, these activities may increase the likelihood of injury. Non-weight-bearing exercises, such as arm exercises with weights, have greater benefit for the wrist and forearm.35 For premenopausal women, exercise is also important, but can be overdone if taken to extreme. Exercise so excessive that it leads to cessation of the menstrual cycle actually contributes to osteoporosis.36 37

Family history
Much of the risk of osteoporosis depends upon genetics, which seems to greatly influence how much bone a person is able to build during their lifetime and how fast they will lose it. Therefore, people who have a parent (or possibly another close relative) who has been diagnosed with osteoporosis are at greater risk for developing the condition than someone with no family history of osteoporosis.38 People with higher genetic risk should adopt dietary and lifestyle habits that will maximize peak bone mass early in life and minimize the bone loss that naturally occurs with aging.

Gastrointestinal disease
Some diseases and conditions of the gastrointestinal tract make it difficult to absorb calcium and other nutrients essential to maintaining healthy bone. Due to this malabsorption problem, conditions such Crohns disease39 and surgical removal of part of the stomach (gastrectomy)40 41 increase the risk of osteoporosis. People with conditions that cause malabsorption should consult a healthcare practitioner to discuss the use of supplements that will help protect them from osteoporosis.

Gender
Osteoporosis is most common in postmenopausal Oriental and white women. Premenopausal women are partially protected against bone loss by the hormone estrogen. Black women often have slightly greater bone mass in early adulthood compared with other women, which helps protect against bone fractures even though postmenopausal black women lose bone mass just as other women do. In men, testosterone partially protects against bone loss even after middle age. However, significant numbers of older men also develop osteoporosis severe enough to cause fractures.42 Women, because of their higher gender-related risk, should adopt dietary and lifestyle habits, such as increasing calcium intake and engaging in weight-bearing exercise, that will maximize peak bone mass early in life and minimize the bone loss that occurs naturally with aging.

Hormone deficiency
Whenever women stop producing estrogendue to natural menopause, intense athletic training, or anorexia nervosaand they do not take replacement hormones, some bone loss is inevitable.43 44 Similar losses occur if men stop producing testosterone, though this is much less common.45 46 The best defense against this type of bone loss is to avoid athletic training intense enough to stop menses; seek treatment for anorexia nervosa and other conditions that reduce hormone production; and to develop above-average bone density early in life through optimum diet and lifestyle habits.

Medications
Corticosteroid medication, even at low doses, increases risk of osteoporosis.47 Steroidal anti-inflammatory drugs reduce the bodys ability to activate vitamin D,48 49 increasing the risk of bone loss. Doctors can measure levels of activated vitamin D (called 1,25 dihydroxycholecalciferol) to determine whether a deficiency exists; if so, activated vitamin D is available by prescription. A study of rheumatoid arthritis patients treated with low doses of prednisone found that those who received 1,000 mg of calcium plus 500 IU of vitamin D per day maintained bone density.50 It makes sense for people taking corticosteroids for longer than two weeks to ask their doctor or pharmacist about calcium and vitamin D supplementation.

Taking thyroid hormones has been reported to increase urinary loss of calcium,51 although recent research suggests that under most circumstances bone density may not be reduced.52 53 54 However, when doses of thyroid medication are higher than necessary and result in suppression of thyroid-stimulating hormone (TSH), adverse effects on bone appear to be more common.55 56 People taking thyroid hormone should have TSH levels measured regularly by their doctor. If TSH levels are low, thyroid hormone dose should be reduced to protect against osteoporosis. Some doctors also suggest that people who supplement thyroid medication for more than a few months consider having 24-hour urinary calcium levels measured. Whether calcium supplementation for people taking long-term thyroid medication is helpful or necessary remains unclear.

Protein intake
The risks of bone loss associated with high protein intake are somewhat unclear. In studies comparing different cultural diets, higher protein intake correlates with increased hip fracture.57 When dietary protein increases, so does the loss of calcium in urine58 59 (though this extra calcium loss is not always statistically significant).60 One study that followed over 85,000 American women for twelve years found that those who ate the most animal protein (meat, poultry, and dairy) had a significantly higher risk of developing osteoporotic fractures.61 In contrast, animal protein intake associated with fewer fractures in another trial.62 Nevertheless, many healthcare practitioners recommend a move toward vegetarian diets for people wishing to avoid osteoporosis or who have already diagnosed with it.

Bone formation requires protein, but people concerned with preservation of bone mass can eat too little protein as well as too much. In one trial of older women (average age 82) who had suffered an osteoporotic fracture, those given a 20 gram per day protein supplement had fewer complications, were less likely to die, and had much shorter hospital stays compared with women not assigned to receive extra protein.63 Similarly, in a three-year study of American women aged 50 to 69 funded by the National Dairy Council, those eating more animal protein had a lower risk of osteoporotic hip fracture compared with those eating less.64 A related double-blind trial in older women who had recently suffered an osteoporotic hip fracture found that a 20 gram per day protein supplement reduced bone loss compared with those not receiving protein.65

Pending further research, these conflicting reports show that drawing the line between too much protein and too little remains elusive. Nonetheless, most studies currently suggest that a life-long intake of high animal protein correlates with an increased risk of developing osteoporosis. Protein supplementation following an osteoporotic fracture in elderly people has improved bone health, but less is known about the effects of protein supplementation in the prevention of osteoporosis. People who wish to protect themselves against osteoporosis and who are concerned about protein intake should have a qualified healthcare practitioner analyze their dietary protein intake. (Most Americans eat levels of protein far above recommended levels.)

Race
Most researchers have reported that Caucasian and Asian women have higher risk for osteoporosis and associated fractures compared to black and Hispanic women.66 67 68 However, preliminary results of a large U.S. study suggest that Native American, Hispanic, and black women have a much greater risk of low bone mass after menopause than was previously believed.69 Some of the effect of race may be due to differences in body composition; for example, black women have greater muscle and bone mass compared to Caucasians.70 People with risk factors for osteoporosis that can not be changed should adopt dietary and lifestyle habits, such as increasing calcium intake and engaging in weight-bearing exercise, that will maximize peak bone mass early in life and minimize the bone loss that occurs naturally with aging.

Salt
Short-term increases in dietary salt result in increased urinary calcium loss, which suggests that over time, salt intake may cause significant bone loss.71 Most researchers have shown that increasing dietary salt increases markers of bone loss in post- (though not pre-) menopausal women,72 73 74 though not all studies have found this relationship.75 Although a definitive link between salt intake and osteoporosis has yet to be proven, many healthcare practitioners recommend that people wishing to protect themselves against bone loss use less salt and eat less highly salted processed and restaurant foods.

Smoking
Smoking leads to both increased bone loss76 77 78 and increased risk of osteoporotic fracture.79 For this and many other health reasons, smoking should be avoided.

Soy
Soy foods such as tofu, soy milk, roasted soybeans, and soy extract powders may be beneficial in preventing osteoporosis. Isoflavones from soy protect animals from bone loss.80 In women, taking 40 grams of soy protein powder containing 90 mg isoflavones increased bone mineral density of the spine in a double-blind trial.81 However, lower intakes (providing 56 mg isoflavones) did not improve bone density in this report. A synthetic isoflavone, ipriflavone, has reduced osteoporotic bone fractures in several reports.82 Although the use of soy in the prevention of osteoporosis looks hopeful, knowing to what extent soy reduces bone loss will require further research.

Vitamin A
One study found that increasing intake of vitamin A in the diet was associated with bone loss and risk for hip fracture, possibly due to a vitamin A-induced stimulation of cells that break down bone.83 Vitamin A is found in high amounts in liver, cod liver oil, fortified dairy products and breakfast cereals, some fish, and vitamin A supplements. Beta-carotene (which can be used by the body to make vitamin A) has not been linked to reduced bone mass. Until more is known, people concerned about osteoporosis and wishing to supplement with vitamin A may consider taking beta-carotene supplements instead.

Vitamin D
Vitamin D increases calcium absorption, and older people with hip fractures are often low in vitamin D.84 85 Vitamin D supplements or injections have reduced bone loss or fractures in some,86 87 88 but not all,89 90 91 studies. Commonly, trials reporting reduced risk of fracture have used the combination of vitamin D and calcium compared with placebo, making it impossible to assess the specific benefit of vitamin D.92 Nonetheless, vitamin D does appear partially protective, at least in certain circumstances. Double-blind research indicates that vitamin D supplementation reduces bone loss in women who consume insufficient amounts of vitamin D from food.93 A double-blind trial also supports the use of higher (700 IU per day) supplemental intakes of vitamin D, particularly as a way to reduce bone loss in women during winter and spring, when vitamin D levels are typically at their lowest.94

While people who get outdoors regularly and live in sunny climates are unlikely to need vitamin D supplementation (particularly during the summer), healthcare practitioners often recommend vitamin D to most other people as a way to help protect bone mass despite remaining inconsistencies in the research. Typical supplemental amounts are between 400 and 800 IU per day, depending on dietary intake and exposure to sunlight.

Cardiovascular Disease (Atherosclerosis/Myocardial infarction)

Cardiovascular disease affects the heart and major blood vessels and is the number one cause of death in the United States. Several health disorders have a role in the development of cardiovascular disease. Refer to these sections for further information: angina, atherosclerosis, high cholesterol, high homocysteine, high triglycerides, and hypertension.

Factors Associated with Cardiovascular Disease

Age

Fiber

Alcohol

Gender

Male Pattern Baldness

Homocysteine (high)

Cardiovascular disease (pre-existing)

Hypertension

Cholesterol (high)

Iron (excess)

Diabetes

Meal frequency

Diet: Cholesterol

Obesity

Diet: Fish and fish oil

Quercetin

Diet: Nuts

Sedentary lifestyle

Diet: Olive oil

Selenium

Diet: Omega-6 oils

Smoking

Diet: Saturated fat

Triglycerides (high)

Diet: Trans fatty acids

Vitamin C

Diet: Vegetarian

Vitamin E

Family history of premature coronary artery disease

Age
Aging increases the risk for cardiovascular disease. Men are considered to be at higher risk after the age of 45 years. Women are usually at low risk for cardiovascular disease until after menopause, and are considered at high risk only after age 55.1

Alcohol
Moderate drinking (one to two drinks per day) increases protective HDL cholesterol.2 This effect is not further affected by the type of alcohol-containing beverage consumed.3 4 Alcohol also acts as a blood thinner,5 an effect that probably lowers the risk of heart disease. However, alcohol consumption can cause liver disease, cancer, high blood pressure, alcoholism, and, at high intake, an increased risk of heart disease. As a result, many healthcare practitioners never recommend alcohol, even for people with high cholesterol. Nevertheless, those who have one to two drinks per day are clearly less likely to have heart disease.6 Therefore, some people at very high risk of heart disease who are not alcoholics, have healthy livers and normal blood pressure, and are not at an especially high risk for cancer, may benefit from light drinking. In deciding whether light drinking might do more good than harm, people with high cholesterol should consult a healthcare practitioner.

Male Pattern Baldness
Men over 40 who have male pattern baldness on the vertex (the topmost part of the skull) have been found to be at increased risk for coronary heart disease-related events, such as nonfatal heart attack and angina pectoris, especially if they have hypertension or high cholesterol levels.7 Depending on the extent of the baldness, the increase in risk ranged from 23pct. to 36pct..

Cardiovascular disease (pre-existing)
People who have already had a heart attack,8 or have been diagnosed with arterial disease in the heart,9 arms, legs, abdomen,10 or neck,11 are at very high risk of having a heart attack. These people should reduce their blood cholesterol levelseven if those levels are in the normal range12and also lower other risks of cardiovascular disease.

Cholesterol (high)
Although it is by no means the only major risk factor, elevated serum cholesterol is clearly associated with a high risk of heart disease in most people. More specifically, a high level of LDL, the bad cholesterol, raises heart disease risks significantly,13 while a high level of HDL, the good cholesterol, lowers the risk.14 Strategies that lower LDL15 or raise HDL16 reduce the risk of heart disease in most people.

High blood cholesterol does not raise heart disease risk as much in the elderly as it does in younger adults,17 though some increased risk is evident.18 Elderly people who already have heart disease may benefit from cholesterol-lowering treatments,19 but whether elderly people with no heart disease symptoms benefit from lowering their cholesterol levels remains unclear.20 21

Diabetes
People with diabetes are at unusually high risk for cardiovascular disease.22 Having diabetes increases a womans heart disease risk more than a mans.23 Controlling blood sugar and reducing other cardiovascular disease risks are important ways for people with diabetes to reduce their risk of heart disease.

Diet: Cholesterol
Diets high in cholesterol have increased the risk of cardiovascular disease in several reports.24 25 Most dietary cholesterol comes from egg yolks. Egg consumption can not only increase serum cholesterol,26 but it can also make LDL (bad) cholesterol more susceptible to free radical damage,27 a change linked to high risk of heart disease. However, eating eggs (and therefore consuming a diet high in cholesterol) does not increase blood levels of cholesterol as much as eating foods high in saturated fat;28 and eating eggs does not appear to increase serum cholesterol at all in people who eat an otherwise low-fat diet.29 Moreover, a recent study found no relationship between the number of eggs eaten per week and the risk of heart disease.30 More research is needed to resolve these conflicting pieces of evidence. As a result, a consensus does not exist among nutritionally oriented doctors regarding the relative importance of removing eggs from the diet.

Diet: Fish and fish oil
Eating fish has been reported to increase HDL (good) cholesterol31 and is associated with a reduced risk of heart disease in most,32 but not all, studies.33 Fish contain very little saturated fat, and fish oil contains EPA and DHA, omega-3 oils that may help protect against heart disease.34

Diet: Nuts
Although nuts are a source of omega-6 oils and most healthcare practitioners do not advocate increased intake of omega-6 oils, research consistently shows that people who frequently eat nuts have a dramatically reduced risk of heart disease35 36 due in part to a lowering of cholesterol levels caused by eating nuts.37 38 Nuts may also reduce the risk of heart disease by replacing harmful foods in the diet.39 40 The most protective nuts may be almonds, walnuts, hazelnuts, and pistachios, while macadamia nuts may be the least beneficial.41 42 43

Diet: Olive oil
People from countries that use significant amounts of olive oil are at low risk for heart disease.44 Olive oil lowers LDL (bad) cholesterol,45 especially when the olive oil replaces saturated fat in the diet.46 Olive oil also contains antioxidants that protect LDL cholesterol particles from free radical damage.47 Oxidized LDL has been linked with increased heart disease.48 Diets enriched with olive oil increase LDL protection in human studies.49 50

Diet: Omega-6 oils
Many vegetable oils, nuts, and seeds contain omega-6 polyunsaturated fatty acids that lower total and LDL (bad) cholesterol.51 Most research has suggested that diets high in omega-6 fatty acids can help prevent heart disease.52 53 54

Paradoxically, a few studies have actually associated polyunsaturated fat intake with an increased risk of atherosclerosis in humans.55 56 Israelis, who have a high intake of omega-6 fatty acids, have a very high risk of cardiovascular disease, though this relationship might be caused by other factors.57 Animal research has suggested that omega-6 fats could also contribute to cancer risks.58 Finally, a higher fat intake from any source makes weight loss more difficult to achieve, an important health goal for overweight people trying to reduce their risk of heart disease.59 For these reasons, most nutritionally oriented doctors and many cardiologists no longer recommend increasing dietary omega-6 polyunsaturated fat for the prevention of heart disease.

Diet: Saturated fat
Diets high in animal foods containing saturated fat are associated with high serum cholesterol,60 plaque, excessive blood clotting in the arteries of the heart,61 and heart disease.62 Significant amounts of animal-based saturated fat are found in beef, pork, veal, poultry (particularly in poultry skins and dark meat), cheese, butter, ice cream, and all other forms of dairy products not labeled fat free. Avoiding consumption of these foods reduces cholesterol and has even been reported to reverse existing heart disease in conjunction with other lifestyle changes.63 In addition to large amounts of saturated fat from animal-based foods, Americans eat small amounts of saturated fat from coconut and palm oils. Palm oil has been reported to elevate cholesterol.64 65 Research results regarding coconut oil are mixed, with some studies finding no link to heart disease66 and other trials finding that coconut oil elevates serum cholesterol.67 68

Diet: Trans fatty acids
Trans fatty acids (TFAs) are found in many processed foods containing hydrogenated oils and in restaurant foods fried in these oils. Margarine often contains particularly high levels of TFAs, and margarine consumption is associated with increased risk of heart disease.69 Eating TFAs increases the ratio of LDL to HDL cholesterol.70 While the relative importance of TFAs as a cause of heart disease is still debated,71 most authorities now agree that reducing trans fatty acids along with saturated fats will likely help prevent heart disease.72 73 Butter contains high amounts of saturated fat and is therefore not a healthful replacement for margarine; many healthcare practitioners now recommend using olive oil instead.

Diet: Vegetarian
Vegetarians have lower blood levels of cholesterol74 and lower risk of heart disease75 than do meat eaters, in part because they avoid animal fat. Vegans (people who eat no meat, dairy, or eggs) have the lowest cholesterol levels,76 and switching to a vegan diet has reversed heart disease when combined with other lifestyle changes.77

Family history of premature coronary artery disease
A person who has an immediate family member who either suffered a heart attack or was diagnosed with premature heart disease is at increased risk for heart disease.78 79 80 Coronary heart disease is considered premature when it occurs in men before the age of 55 or in women before the age of 65.81 People with a family history of premature heart disease should strive to minimize all of their other cardiovascular disease risk factors.

Fiber
Soluble fiber from beans,82 oats,83 psyllium seed,84 and fruit pectin85 has lowered cholesterol levels in most trials.86 Healthcare practitioners often recommend that people with elevated cholesterol eat more of these high soluble fiber foods. However, even grain fiber (which contains insoluble fiber and does not lower cholesterol) has been linked to protection against heart disease, though the reason for that protection remains unclear.87

Gender
Though cardiovascular disease is the leading cause of death in both male and female Americans, adult men of any age have a higher risk of heart disease than do younger (premenopausal) women. Following menopause, women gradually develop heart disease risks closer to that of men.88 89

Homocysteine (high)
Blood levels of an amino acid called homocysteine have been linked to atherosclerosis and heart disease in most research,90 91 though uncertainty remains about whether elevated homocysteine actually causes heart disease.92 93 Homocysteine can be measured by a laboratory test, and elevated levels can be treated with vitamins.

Hypertension
Hypertension is the medical term for high blood pressure. Hypertension is a major risk factor for cardiovascular disease, and the risk increases as blood pressure rises.94 Even after blood pressure has normalized as a result of drug treatment, people with a history of high blood pressure are still at higher risk for cardiovascular disease compared to people who never had high blood pressure.95 Many dietary and lifestyle changes can lower blood pressure and should be adopted by people with high blood pressure.

Iron (excess)
In 1992, a Finnish study found a strong link between unnecessary exposure to iron and increased risk for heart disease.96 Since then many studies have not found that link,97 98 99 though several have confirmed the outcome of the original report.100 101 One 1999 analysis of 12 studies looking at iron status and heart disease found no overall relationship,102 but another 1999 analysis of published reports came to a different conclusion.103 While the effect of unnecessary exposure to iron, including iron supplements, on the risk of heart disease remains unclear, there is no benefit in supplementing iron in the absence of a deficiency. Nutritionally oriented doctors recommend that people who are not iron deficient avoid iron supplements, at least until more is known.

Meal frequency
Studies have found that people who eat small, frequent meals during the day (sometimes called grazing) have lower cholesterol levels compared with those who eat two or three large meals per day.104 105 106 One study also found evidence of reduced atherosclerosis (hardening of the arteries) in people eating small, frequent meals.107 Redistributing the contents of two or three large meals per day into four or five smaller meals may be beneficial for reducing cardiovascular disease risk.

Obesity
Excess body fat increases heart disease risk,108 in part because obesity can lead to diabetes, hypertension, low HDL (good) cholesterol, and high LDL (bad) cholesterolall risk factors for heart disease. Abdominal weight gain is especially likely to increase heart disease risk.109 110 Losing excess body weight reduces many risk factors for heart disease. Unfortunately, unsuccessful long-term weight control resulting in large fluctuations in body weight (often called yo-yo dieting) may also increase risk of heart disease, according to some,111but not all, reports.112 113

Quercetin
Quercetin, a flavonoid, protects LDL (bad) cholesterol from damage.114 Some,115 116 117 but not all,118 119 studies have reported an association between consumption of foods high in quercetin and a low risk of heart disease. Quercetin is found in apples, onions, black tea, and as a supplement. In some studies, the dietary level of quercetin associated with protection from heart disease has been as low as 35 mg per day.

Sedentary lifestyle
A sedentary lifestyle has been reported to double the risk of cardiovascular disease.120 Conversely, moderate exercise, including brisk walking for 30 minutes per day, has a well-known protective effect against cardiovascular disease.121 122 The benefits of exercise are at least partially attributable to reductions in body weight, blood pressure, triglycerides, cholesterol, and glucose intolerance.

Selenium
In some studies, people who consume more selenium from their diet have a lower risk of heart disease.123 124 In one double-blind report, individuals who already had one heart attack were given 100 mcg of selenium per day or placebo for six months.125 At the end of that trial, four deaths from heart disease occurred in the placebo group, compared with none in the selenium group (although the numbers were too small for this difference to be statistically significant). Some nutritionally oriented doctors recommend that people with atherosclerosis supplement with 100200 mcg of selenium per day.

Smoking
Both smoking126 and exposure to second-hand smoke127 significantly increase cardiovascular disease risk. If you are a smoker, you should quita critical step in reducing the risk of cardiovascular disease and many other health conditions. Both smokers and nonsmokers should avoid exposure to second-hand smoke.

Triglycerides (high)
A person with high blood triglycerides most often also has either a high total cholesterol level and/or a low HDL (good) cholesterol level. Perhaps as a result, researchers have had a hard time hunting for the effect of high triglycerides on heart disease independent of the effect of high total cholesterol or low HDL cholesterol.128 129 130 Nonetheless, a recent analysis of previous studies has shown that high triglycerides are associated with an increased risk for heart disease independent of other factors.131 The outcome of some research suggests that triglyceride levels in the high range of normal parameters should also be lowered to reduce the risk of heart disease.132

Vitamin C
Experimentally increasing homocysteine levels in humans has led to temporary dysfunction of the cells lining blood vessels. Researchers are concerned that this dysfunction may be linked to atherosclerosis and heart disease. Vitamin C has been reported to reverse the dysfunction caused by increases in homocysteine.133 Vitamin C also protects LDL (bad) cholesterol from oxidative damage.134

Despite these protective mechanisms attributed to vitamin C, researchers have been unable to consistently associate high vitamin C intake to a reduced risk of heart disease. Trials failing to find vitamin C protective have mostly been conducted in groups of people that all consume at least 90 mg of vitamin C per daya level beyond which further protection of LDL cholesterol may not occur. Studies comparing people whose diets contain lower amounts of vitamin C to people whose amounts are significantly higher than 90 mg per day, however, have found an association between increasing dietary vitamin C and protection from heart disease. Therefore, leading vitamin C researchers have begun to suggest that vitamin C may be important in preventing heart disease, but only up to modest levels: perhaps 100200 mg per day.135

Vitamin E
Vitamin E is an antioxidant that protects LDL (bad) cholesterol from oxidative damage136 and has been linked to prevention of nonfatal heart disease in double-blind research.137 Many doctors recommend 400800 IU of vitamin E per day to lower the risk of atherosclerosis and heart attacks. However, a large double-blind trial recently found no benefit from vitamin E supplementation in the prevention of non-fatal heart attacks among people at high risk.138 Participants, who had a history of diabetes or existing cardiovascular disease, took 400 IU of natural vitamin E for 4.5 years. It is not known why these results so strongly contradict previous findings of a protective effect from vitamin E.139 140 141 Further studies are needed to resolve the conflicting findings of these large trials.

What are the symptoms of Crohns disease

Chronic diarrhoea with abdominal pain, fever, loss of appetite, weight loss, and a sense of fullness in the abdomen are the most common symptoms. About one-third of people with Crohns have a history of anal fissures (linear ulcers on the margin of the anus) or fistulas (abnormal tube-like passages from the rectum to the surface of the anus).

Medical treatments

The over the counter antidiarrhoeal drug loperamide (Imodium A-D) may be used in Crohns patients with diarrhoea. Anal irritation and loose stools may sometimes be improved by giving bulk-forming laxative such as methylcellulose (Citrucel) or psyllium (Fiberall, Konsyl, Metamucil, Perdiem).

Diphenoxylate (Lomotil) is the prescription drug most often used to control diarrhoea. Cramps may be treated with anticholinergic drugs, such as L-hyoscyamine (Levsin, Levbid) and belladonna (Belladonna Tincture). Sulfasalazine (Azulfidine) is used in patients with mild to moderate colitis. Oral corticosteroids, such as prednisone (Deltasone), may be used during acute flare-ups. However, long-term corticosteroid therapy does more harm than good. Certain immunosuppressive drugs may also be effective, including azathioprine (Imuran) and 6-mercaptopurine (Purinethol). Secondary bacterial infections are managed with antibiotics such as tetracycline (Sumycin) and doxycycline (Vibramycin).

Dietary changes that may be helpful

A person with Crohns disease might consume more sugar than the average healthy person.1 A high-fibre, low-sugar diet led to a 79pct. reduction in hospitalizations compared with no dietary change in one group of people with Crohns disease.2 Another trial compared the effects of high- and low-sugar diets in people with Crohns disease.3 People with a more active disease were reported to fare better on the low-sugar diet than those eating more sugar. Several people on the high-sugar diet had to stop eating sugar because their disease grew worse. While details of how sugar injures the intestine are still being uncovered, doctors often suggest eliminating all sugar (including soft drinks and processed foods with added sugar) from the diets of those with Crohns disease.

A diet high in animal protein and fat (from foods other than fish) has been linked to Crohns disease in preliminary research.4 As with many other health conditions, it may be beneficial to eat less meat and dairy fat and more fruits and vegetables.

Some people with Crohns disease have food allergies and have been reported to do better when they avoid foods to which they are allergic. One study found that people with Crohns disease are most likely to react to cereals, dairy, and yeast.5 Increasingly, bakers yeast (found in bread and other bakery goods) has been implicated as a possible trigger for Crohns disease.6 Yeast and some cheeses are high in histamine, which is involved in an allergenic response. People with Crohns disease lack the ability to break down histamine at a normal rate,7 so the link between yeast and dairy consumption and Crohns disease occurrence may not be coincidental. However, the allergy theory cannot account for all, or even most, cases of Crohns disease.

Elemental diets contain amino acids (rather than whole proteins, which can stimulate allergic reactions) and are therefore considered hypoallergenic. They have been used extensively as primary therapy in people with Crohns disease,8 9 10 with remission rates comparable to those of steroid drugs. Nevertheless, diets containing intact proteins derived from dairy and wheat have proven equally effective at controlling the symptoms of Crohns disease.11 12 13 Until more is known, it is premature to conclude that food allergy plays a significant role in the development of Crohns disease or that a hypoallergenic diet is any more likely to help than a diet whose protein is only partially broken down.

In one trial, people with Crohns disease were asked which foods aggravated their symptoms.14 Those without ileostomies found nuts, raw fruit, and tomatoes to be most problematic, though responses varied from person to person, and other reports have displayed different lists.15 (Ileostomies are surgical passages through the wall of the abdomen into the intestine that allow the intestinal contents to bypass the rectum and drain into a bag worn on the abdomen.) People with Crohns disease wishing to identify and avoid potential allergens should consult a doctor.

There is preliminary evidence that people who eat fast foods at least two times per week more than triple their risk of developing Crohns disease.16

Which Diet Is Right for Me

Diet and health

Finding the diet that fits you best can make all the difference to your health and weight control goals. To work on your weight, first try asking yourself: What kinds of foods are the hardest for me to give up Whats my optimal, healthiest weight Diets arent just about losing weight, however. Changing what you eat can also support the treatment of many types of health conditions.

While advocates say that the following diets may help control or prevent certain conditions, these claims may or may not be supported by controlled clinical studies or published scientific articles. For more complete information, go to the full article on the health concern or diet that interests you. You should always consult your doctor before changing your treatment (including diet) for any health concern.

Whatever your goals, if you arent sure which diets best fits your self-care needs, this list can be a place to start.

Diets by feature

Diet

Restricts src=http://www.healthnotes.info/http/ukfull/images/Diet/dieticonRestricts.gif border=0andgt;Restricts

Emphasizes

Recommends

Atkins

Unrestricted calories from protein and fat

Carbs

Protein

Exercise

Blood Type

Food recommendations depend on blood type

Specific foods

Dean Ornish

Designed for heart-disease prevention and weight loss

Restricts src=http://www.healthnotes.info/http/ukfull/images/Diet/dieticonRestricts.gif border=0andgt;Fats

Fibre Vegetarian

Exercise

Fasting

Suitable for short-term only

All foods

Glycaemic Index

Supports management of blood sugar disorders

Carbs

Fibre

High-fibre

Reduces risk of chronic diseases

Fibre Vegetarian

Low-carbohydrate

Includes Atkins, South Beach, and others

Carbs

Protein

Low-fat

Includes Dean Ornish and Pritikin diets

Fats

Pritikin

Designed for heart disease prevention

Fats

Fibre Vegetarian

Exercise

The Zone

Designed for athletic performance and overall health

Carbs

Protein

Low-allergen

For relief of symptoms caused by food allergies

Specific foods

South Beach

Emphasizes healthy fats and healthy carbs

Carbs Fats

Fibre

Weight Watchers

Balanced diet plan with weekly group support meetings

Calories Fats

Fibre

Exercise

Diet and health

Advocates claim that their diets may help or control the following common health concerns. Before trying a new diet be sure to read the full diet and health conditions articlesand remember to check with your doctor before trying new eating habits.

Allergies

Low-allergen diet

Rheumatoid arthritis

Fasting diet

Low-allergen diet

Cancer prevention

High-fibre diet

Low-fat diet

Ornish diet

Pritikin diet

Colon disorders

High-fibre diet

Constipation

High-fibre diet

Diabetes type 2

Atkins diet

Glycaemic Index diet

Low-carbohydrate diet

Low-fat diet

Pritikin diet

The Zone diet

Diverticular disease

High-fibre diet

Duodenal ulcers

High-fibre diet

Low-allergen diet

Certain Gastrointestinal Disorders (Constipation, Crohns disease, Diarrhoea, Duodenal ulcer, Gallstones, Indigestion, Irritable bowel)

High-fibre diet

Low-allergen diet

Heart disease

Dean Ornish diet

Glycaemic Index

High-fibre diet

Low-fat diet

Pritikin diet

High blood pressure

Dean Ornish diet

Low-fat diet

High cholesterol

Dean Ornish diet

Low-carbohydrate diet

Low-fat diet

Pritikin diet

Hypoglycaemia

Glycaemic Index

High-fibre diet

Low-carbohydrate diet

Insulin resistance

Glycaemic Index

High-fibre diet

Low-carbohydrate diet

Migraine

Tyramine-free diet

Histamine-free diet

Additive-free diet

Nitrite-free diet

Low-allergen diet

Certain respiratory disorders (Asthma, Hay Fever, Sinusitis, Sinus congestion)

Low-allergen diet

Obesity

About one-third of the U.S. population is overweight. Excess body weightand, in particular, male pattern obesity characterized by excess abdominal fat as opposed to fat accumulation in the thighs and buttocks is implicated as a risk factor for many different diseases. Therefore, maintaining a healthy body weight is prudent. Unfortunately, keeping lost weight off is very difficult for most people.

Health Problems Associated with Obesity
(The following list is comprehensive, although not necessarily exhaustive.
Contact your health care professional for more information.)

Benign prostatic hyperplasia (BPH)

Infertility (female)

Cancer

Mortality

Cardiovascular disease

Osteoarthritis

Cholesterol (high)

Stroke

Diabetes

Triglycerides (high)

Gallstones

Uterine fibroids

Hypertension

Work disability

Immune function

Benign prostatic hyperplasia (BPH)
The prostate is a small gland that surrounds the neck of the bladder and urethra in men. Its major function is to contribute to seminal fluid. If the prostate enlarges, pressure can be put on the urethra, acting like a partial clamp and causing related symptoms. This condition is known as benign prostatic hyperplasia (BPH). Obesity has been linked to an increased risk of developing BPH.1

Cancer
Cancer is a general term for more than 100 diseases that are characterized by uncontrolled, abnormal growth of cells. Cancer is the second leading cause of death in Americans. Obesity has been linked to cancers of the endometrium, colon, kidney, and breast (in postmenopausal women only) and possibly to cancers of the ovary and prostate.2

Cardiovascular disease
Cardiovascular disease is the number one cause of death in the United States. Obesity increases the risk of cardiovascular disease.3 Obesity is associated with increased risk for heart attack, particularly among younger people.4 One study found this relationship increased in women who also had a history of diabetes or high cholesterol.5 Nutritionally oriented doctors encourage people who are at risk for heart attack and are overweight to lose the extra weight and keep it off.

Cholesterol (high)
Although it is by no means the only major risk factor, elevated serum cholesterol is clearly associated with a high risk of heart disease. Obesity increases the risk of heart disease,6 in part because weight gain lowers HDL cholesterol (the good cholesterol).7 Weight loss increases HDL,8 thereby reducing (improving) the ratio between total cholesterol and HDL, a change linked to lowered risk of heart disease.

Diabetes
People with diabetes cannot properly process glucose, a sugar the body uses for energy. As a result, glucose stays in the blood, causing blood glucose to rise. At the same time, however, the cells of the body can be starved for glucose. Diabetes can lead to poor wound healing, higher risk of infections, and many other problems involving the eyes, kidneys, nerves, and heart.

Most people with type 2, or non-insulin dependent diabetes mellitus, are obese.9 Excess abdominal weight does not stop insulin formation,10 but it does make the body insensitive to insulin.11 Excess weight even makes healthy people pre-diabetic.12 Weight loss reverses this problem.13 Type 2 improves with weight loss in most studies.14 15 16

Being overweight does not cause type 1, or insulin dependent diabetes mellitus, but it does increase the need for more insulin. Therefore, people with type 1 should achieve and maintain appropriate body weight.

Gallstones
Gallstones are formed in the gallbladder and primarily consist of cholesterol. They are commonly associated with bile that contains excessive cholesterol, a deficiency of other substances in bile (bile acids and lecithin), or a combination of these factors.

Some,17 but not all studies have found apparent links between obesity and increased risk of gallstone formation.18

Hypertension
Hypertension is the medical term for high blood pressure. The cause of most hypertension remains unknown. Many people with high blood pressure are overweight. Weight loss can lower blood pressure significantly in those who are both overweight and hypertensive.19 People with hypertension who are overweight should talk with a nutritionally oriented doctor about a weight loss program.

Immune function
Both excessive thinness and severe obesity are associated with impaired immune responses,20 and obesity has increased the risk of infection in hospitalized patients according to preliminary research.21 However, these effects may not occur with mild to moderate obesity in otherwise healthy people, and attempts to lose weight through dietary restriction may actually be harmful to the immune system.22 The detrimental effects of both excess weight and weight-loss diets appear to be offset when people regularly perform aerobic exercise.23 24

Infertility (female)
Excessive weight can be a cause of female infertility.25 Infertile women who are overweight should consult a nutritionally oriented physician to develop a weight loss plan.

Mortality
A clear association between obesity and increased mortality (higher death rate) has been reported.26

Osteoarthritis
Osteoarthritis is a common disease that develops when linings of joints fail to maintain normal structure, leading to pain and decreased mobility. Obesity increases the symptoms suffered by people with osteoarthritis of weight-bearing joints. Weight loss is thought by arthritis experts to be of potential benefit, at least in reducing pain in weight-bearing joints.27

Stroke
Strokes are caused either by a lack of blood supply to the brain or by hemorrhage in the brain. Depending on the area of the brain that is damaged, a stroke can cause coma, reversible or irreversible paralysis, speech problems, and dementia. Abdominal obesity has been associated with an increased risk of stroke.28 Smoking (which lower weight but increases the risk of stroke) and other factors sometimes lower the strength of the association between obesity and stroke risk. Nonetheless, scientists believe that being overweight significantly increases the risk of suffering a stroke.29

Triglycerides (high)
Most studies indicate that people with elevated triglycerides (a type of fat in the blood) are at higher risk of heart disease. Obesity increases triglyceride levels.30 Maintaining ideal body weight helps protect against elevated triglyceride levels. Many nutritionally oriented doctors encourage overweight people who have elevated triglycerides to lose the extra weight.

The Zone Diet

The Zone Diet was developed by Barry Sears, Ph.D., and popularized by Dr. Sears best-selling book, The Zone: A Dietary Road Map to Lose Weight Permanently: Reset Your Genetic Code: Prevent Disease: Achieve Maximum Physical Performance: Enhance Mental Productivity.

The foundation of the Zone Diet is the relationship between the hormone insulin and substances called eicosanoids. Eicosanoids are hormone-like substances that control many vital physiological functions, including those of the cardiovascular system, immune system, and nervous system. Dr. Sears believes that certain eicosanoids are good and others are bad.

Heres where insulin enters the picture. When insulin levels are high, bad eicosanoids are produced. Dr. Sears contends that his Zone Diet, which contains 40pct. carbohydrate, 30pct. protein, and 30pct. fat, is the ideal diet for keeping insulin levels in check.

South Beach Diet

The South Beach diet is based on the premise that choosing the right carbohydrate and fat sources can help people reduce their appetite, lose weight, and prevent chronic diseases such as heart disease and diabetes. The diet emphasizes carbohydrate foods with a low glycaemic index and fats that dont raise blood cholesterol. The South Beach diet shares features with several other diets, including Atkins, low-carbohydrate, and low-glycaemic-index diets. Like the Atkins diet, the South Beach diet begins with an initial phase of very low carbohydrate intake; however, unlike Atkins, it only allows foods low in unhealthy fats. The South Beach diet follows the first phase with two additional phases that allow low-glycaemic-index carbohydrate foods to be included in increasing amounts. During these phases, the dieter following the South Beach diet is permitted more carbohydrate foods than the Atkins diet recommends. If weight loss stops or the dieter strays from the diet, he or she repeats the first phase. The third phase is a weight-maintenance diet that primarily restricts only high-glycaemic-index foods or foods high in saturated and hydrogenated fats. Again, if weight loss stops or the dieter strays from the diet, the dieter repeats the first phase.

Low-Carbohydrate Diet

Many currently popular diets are designed to lower carbohydrate consumption, but they frequently differ from each other in important ways. Some (e.g., Atkins, Protein Power) restrict carbohydrate to the point that a condition of ketosis is reached (ketosis is a condition wherein the body breaks down fats into ketones, which can either be used either as energy, or eliminated from the body via the breath or urine. Other low carbohydrate diets (e.g., Zone, Life Without Bread) are less restrictive, and some (e.g., Sugar Busters) seek to eliminate only sugars and foods that raise blood sugar levels excessively (e.g., high-glycaemic-index foods). When total carbohydrate intake is reduced, protein and fat intake represent a larger proportion of the diet. Some low carbohydrate diets (e.g., Zone, Insulin Resistance Diet) recommend replacing carbohydrate with healthy sources of protein and fat; others do not restrict any type of protein or fat sources (e.g., Atkins, Protein Power).

The Atkins Diet is a high-protein, low-carbohydrate weight loss diet developed by Robert Atkins, MD, during the 1960s. In the early 1990s, Dr. Atkins brought his diet back into the nutrition spotlight with the publication of his best-selling book Dr. Atkins New Diet Revolution.

The Atkins Diet severely restricts the consumption of carbohydrate-rich foods and encourages the consumption of protein and fat. The diet is divided into four phases: Induction, Ongoing Weight Loss, Premaintenance, and Maintenance. During the Induction phase (the first 14 days of the diet), carbohydrate intake is limited to no more than 20 grams per day. No fruit, bread, grains, starchy vegetables, or dairy products (except cheese, cream, and butter) are allowed during this phase. During the Ongoing Weight Loss phase, dieters experiment with various levels of carbohydrate consumption until they determine the most liberal level of carbohydrate intake that allows them to continue to lose weight. Dieters are encouraged to maintain this level of carbohydrate intake until their weight loss goals are met. During the Premaintenance and Maintenance phases, dieters determine the level of carbohydrate consumption that allows them to maintain their weight. To prevent weight regain, dieters are told to maintain this level of carbohydrate consumption, perhaps for the rest of their lives. According to Dr. Atkins, most people must limit their carbohydrate intake to no more than 60 grams per day to keep lost weight off.